'We can hide so much behind a smile' A post natal depression story

Cathie's mental health was so dire that a psychologist suggested she get her tubes tied, but she hid it so well that even her obstetrician husband had no idea for two years.

The happy looking couple in the photograph are Vijay Roach and Catherine Knox. Vijay was a hospital resident on his way to becoming a gynaecologist/obstetrician, and Cathie held a job in marketing. They lived on Sydney's Northern Beaches and although their first pregnancy was unplanned, they soon became happy and excited over the prospect of starting a family together. You could say things were going really well for them both.

But although the smiles may have remained on the outside, they weren't always present on the inside.

"It all went pear-shaped when all of her plans to keep working, to be herself, to do her own thing were taken away from her"

Vijay told Kidspot that Cathie's initial plans to have an intervention-free pregnancy began to unravel when she was diagnosed with severe high blood pressure. Cathie was admitted to hospital, put on medication and told she would no longer be able to birth in the birth centre. Instead, Cathie was induced and then had an experience that Vijay describes as "a horrible, horrible birth which both of us found extremely traumatic."

As if all those things weren't enough, Cathie lost further control when she was unable to breastfeed, then not long after the birth of their first son Tom, the young couple discovered that they were expecting again.

Vijay said, "I don't think she recognised it and I certainly didn't recognise it, but she was already developing anxiety."

Despite finally experiencing a positive birth experience with their second son, Jack, everything started to fall apart a few months later.

"For two years each day I’d leave the house, she’d put the children in their cots and then she’d go and sit on the kitchen floor and just rock herself. She was having suicidal thoughts. That went on for two years," said Vijay.

But despite his medical insight, it took someone else to point out that Cathie could have been suffering from post natal depression.

"Despite the fact that I was a doctor, despite the fact that we loved one another, neither of us recognised how terribly unwell she was until by chance someone suggested she could have PND," he said.

Cathie was admitted to a psychiatric institution for six weeks, went on medication, and they began seeing a psychologist together on a regular basis.

This photo of Tom and Jack always sets Cathie off, who wishes she could "go back and in time, scoop them up [and] hug them." Image: supplied.

"We basically crawled our way back"

Vijay talks very proudly of his wife, for everything she has achieved. In our chat, he was very clear that he was not to be painted as "the stalwart who supported her and held it all together and kept the family going." In fact, Vijay and Cathie both share their story to show others that anxiety and depression does not discriminate, that he of all people should have recognised the signs, but it's not always so easy when it's a part of your daily life.

Like one in ten men, Vijay says that he was more than likely experiencing undiagnosed anxiety and/or depression himself. "I was not supportive. I was not understanding, and I fell apart as well while Cathie fell apart."

Vijay and Cathie both speak openly about their experience to raise awareness and break down some of the taboo that surrounds mental health issues, but also because their story is one of hope.

"We are recovered," said Vijay. "We recognise that this happens to other people, because in a way I’m supposed to be an obstetrician that would therefore have insight. We’re a competent, intelligent, well-educated, well-connected family ... but despite all of those advantages, this was a disease that affected us as well."

"Have your tubes tied"

As Cathie was discharged from the psychiatric institution, a medical professional said to her, "Now you know there’s a risk of recurrence, so you should go across the road to Royal North Shore Hospital and have your tubes tied."

Vijay said that Cathie had always wanted more children, and this only added fuel to that desire. "She decided not to prove him wrong one but three more times."

Vijay and Cathie went on to have a further three children. Although the anxiety and depression was still something they had to contend with, they were prepared and better able to manage it with the three subsequent pregnancies.

Cathie with her four children, the night before the fifth baby was born. Image: supplied.

The Gidget Foundation

Vijay and Cathie became heavily involved with the Gidget Foundation, which is a not for profit organisation supporting the emotional wellbeing of new parents and their families, while providing education for health professionals and the community.

The Gidget Foundation raises funds and awareness for perinatal anxiety and depression. They also run Gidget House, which provides free services for anyone affected by anxiety or depression in pregnancy or the year following birth of the baby.

The Gidget Foundation has also helped introduce screening programs into two private hospitals, which they are hoping to expand on.

Vijay has also played a role in the implementation of mental health assessment as a standard in obstetric care, bringing forth a focus on mental health alongside physical health in pregnancy.

Who doesn't love a happy ending?

Vijay and Cathie's relationship was on some very uncertain ground all those years ago, but there is no doubt that what they have now was borne from some very tough struggles and a strong love and commitment to each other.

"I think we are an extraordinary couple," said Vijay. "There is some kind of strength in our relationship and connectedness that came out of that horrible adversity."

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